Opioid knowledge and perceptions among Hispanic/Latino residents in Los Angeles.

Background: Most research and health education efforts to address the opioid crisis have focused on white populations. However, opioid use, opioid use disorder, and opioid overdose deaths also have increased among Hispanics. Methods: This study conducted four focus groups in a Hispanic community in Southern California (N = 45) to assess opioid-related knowledge, perceptions, and preventive behaviors among Hispanic residents. Focus group questions assessed medication storage, disposal, and sharing; opioid-related knowledge; how to recognize a drug problem; perceptions of the extent of the opioid use problem in the community; and sources of help for drug problems. Results: Qualitative analysis revealed that most participants were aware of the potential dangers of opioids and the importance of keeping them out of the reach of children. However, participants reported stockpiling, sharing, and borrowing prescription medications for financial reasons. They perceived marijuana use as a larger problem in the community than opioids. They were familiar with the behavioral indicators of opioid addiction, but they were unaware of the availability of naloxone to reverse overdoses. They were ambivalent about searching for information about opioids and treatment options because they lacked self-efficacy to find accurate information on the internet. Conclusions: Findings identify some knowledge gaps about opioids among Hispanics and suggest opportunities for culturally accessible health education to provide Hispanics with information about opioid use disorder, overdose reversal, and treatment options.

Sweet Temptations: How Does Reading a Fotonovela About Diabetes Affect Dutch Adults with Different Levels of Literacy?

Recent studies suggest that health-related fotonovelas-booklets that portray a dramatic story using photographs and captions-may be effective health communication tools, especially for readers with a low level of literacy. In this experiment, effects on knowledge and behavioral intentions were assessed of a fotonovela originally developed for a Latin-American audience. Dutch readers from a low literacy group (N = 89) and a high literacy group (N = 113) were randomly assigned to one of three conditions: a fotonovela condition (all captions translated into Dutch), a traditional brochure condition (also in Dutch), and a control condition. On knowledge about diabetes, participants in the fotonovela condition outperformed participants in both other conditions. This finding was consistent across literacy levels. On behavioral intentions, however, readers of the fotonovela did not score significantly higher than participants in the other conditions. We also evaluated hypotheses proposed in the Entertainment Overcoming Resistance Model (EORM; Moyer-Gusé, 2008) on the possible mechanisms underlying persuasion through narratives. No support was found for the mechanisms proposed in the EORM. The outcomes of this study suggest that a fotonovela may be a valuable health education format for adults with varying levels of literacy, even if it was developed for a target group with a different cultural background.

Evaluation of an Audio-Visual Novela to Improve COVID-19 Knowledge and Safe Practices Among Spanish-Speaking Individuals with Schizophrenia.

In the United States, the health and economic consequences of the COVID-19 pandemic have disproportionately affected the Latinx community. Within the Latinx community, people with schizophrenia-spectrum disorders are more susceptible to exposure to the virus. Given their increased risk of contracting and getting sick from the virus, efforts targeting the Latinx population should focus on increasing knowledge and safe practices associated with COVID-19. We developed a 10 min animated, Spanish-language audio-visual novela designed to improve knowledge, attitudes, and behaviors regarding COVID-19. Latinx adults with schizophrenia (N = 100) at a community mental health center in Los Angeles were randomly assigned to watch the novela or a non-COVID video (control group). Participants completed surveys immediately before and one month after viewing the material. One month after watching the audio-visual novela, subjects endorsed a greater likelihood of seeking a COVID-19 vaccine than control subjects. No other significant differences were observed between the two conditions. The findings of this study suggest that the presentation of health information in a relevant, engaging, and appealing manner may be useful way to improving salutary health behaviors of Latinx people with schizophrenia-spectrum disorders.

Depression fotonovela: development of a depression literacy tool for Latinos with limited English proficiency.

Stigma, low health literacy, lack of knowledge, and misconceptions about depression are considered pervasive barriers contributing to the disparities Latino adults with limited English proficiency (LEP) face in accessing and receiving high-quality depression care. The development of culturally and linguistically appropriate health literacy tools, such as fotonovelas, can help address these barriers to depression care in the Latino community. Fotonovelas are booklets that use posed photographs with simple text bubbles to portray soap opera stories that convey educational messages. The aim of this study is to describe the development of a depression fotonovela adapted for Latinos with LEP. We present the conceptual model that informed this depression literacy tool and illustrate how findings from several studies were used to identify educational messages. Our production process delineates practical steps of how to use a multistakeholder approach to develop a health-related fotonovela. Implications for practice of this innovative depression literacy tool are discussed.

Focus group evaluation of "Secret Feelings": a depression fotonovela for Latinos with limited English proficiency.

In this study, the authors examined reactions of Latino adults with limited English proficiency (LEP) to a culturally and linguistically adapted depression fotonovela, titled "Secret Feelings." Fotonovelas are popular health education tools that use posed photographs, text bubbles with simple text, and dramatic narratives to engage audiences and raise their awareness and knowledge about specific health issues. Four focus groups (N = 32) were conducted at an adult school program (e.g., GED classes). Content analysis was used to generate themes from transcripts and memos. "Secret Feelings" was viewed as an entertaining, engaging, and educational tool that helped combat stigma toward depression and its treatments in the Latino community. Despite learning about depression, participants reported they wanted more information about the causes of depression, the process of recovery, and felt that the story did not shift their apprehensions toward antidepressants. The findings suggest that "Secret Feelings" is a promising depression literacy tool for Latinos with LEP that can raise awareness and knowledge about depression and its treatments, reduce stigma toward depression and antidepressant medications, and model appropriate help-seeking behaviors.

Comparing the impact on Latinos of a depression brochure and an entertainment-education depression fotonovela.

OBJECTIVE: The purpose was to evaluate the impact of a depression fotonovela in increasing knowledge of depression symptoms and treatments and reducing stigma among Latinos. METHODS: Data were from a randomized controlled trial in which Latinos from adult schools (N=132) were assigned to receive the fotonovela or a depression brochure and were assessed on knowledge and stigma measures before and after reading the material and one month later. Random-effects linear and logistic regression models assessed changes within and between groups. RESULTS: No significant differences were found between groups in symptom knowledge, social distance, and perceptions of dangerousness. Gains in depression treatment knowledge were significantly greater for the fotonovela than for the depression brochure group. CONCLUSIONS: Findings suggest that a depression fotonovela informed by an entertainment-education approach is a useful tool for improving depression treatment knowledge among Latinos but is limited in improving symptom knowledge and reducing stigma related to social distance and perceptions of dangerousness.

Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults.

Fotonovelas-small booklets that portray a dramatic story using photographs and captions-represent a powerful health education tool for low-literacy and ethnic minority audiences. This study evaluated the effectiveness of a depression fotonovela in increasing depression knowledge, decreasing stigma, increasing self-efficacy to recognize depression, and increasing intentions to seek treatment, relative to a text pamphlet. Hispanic adults attending a community adult school (N = 157, 47.5 % female, mean age = 35.8 years, 84 % immigrants, 63 % with less than high school education) were randomly assigned to read the fotonovela or a low-literacy text pamphlet about depression. They completed surveys before reading the material, immediately after reading the material, and 1 month later. The fotonovela and text pamphlet both produced significant improvements in depression knowledge and self-efficacy to identify depression, but the fotonovela produced significantly larger reductions in antidepressant stigma and mental health care stigma. The fotonovela also was more likely to be passed on to family or friends after the study, potentially increasing its reach throughout the community. Results indicate that fotonovelas can be useful for improving health literacy among underserved populations, which could reduce health disparities.